Hepatozoon canis in hunting dogs from Southern Italy: distribution and risk factors.

Hepatozoon canis is a hemoprotozoan organism that infects domestic and wild carnivores throughout much of Europe. The parasite is mainly transmitted through the ingestion of infected ticks containing mature oocysts. The aims of the present survey were to determine the prevalence of H. canis in hunting dogs living in Southern Italy and to assess potential infection risk factors. DNA extracted from whole blood samples, collected from 1433 apparently healthy dogs living in the Napoli, Avellino, and Salerno provinces of Campania region (Southern Italy), was tested by a quantitative real-time polymerase chain reaction (qPCR) assay to amplify H. canis. Furthermore, the investigated dog population was also screened by qPCR for the presence of Ehrlichia canis, a major tick-borne pathogen in Southern Italy, in order to assess possible co-infections. Two hundred dogs were H. canis PCR-positive, resulting in an overall prevalence of 14.0% (CI 12.2-15.9). Breed category (P < 0.0001), hair coat length (P = 0.015), and province of residence (P < 0.0001) represented significant risk factors for H. canis infection. The presence of H. canis DNA was also significantly associated with E. canis PCR positivity (P < 0.0001). Hunting dogs in Campania region (Southern Italy) are frequently exposed to H. canis, and the infection is potentially associated with close contact with wildlife. Further studies are needed to assess the pathogenic potential of H. canis, as well as the epidemiological relationships between hunting dogs and wild animal populations sharing the same habitats in Southern Italy.

Relationship between serum symmetric dimethylarginine concentration and glomerular filtration rate in cats.

BACKGROUND: Direct measurement of glomerular filtration rate (GFR) is the preferred method to assess renal function in cats, but it is not widely used in the diagnosis of chronic kidney disease (CKD). In cats with CKD, symmetric dimethylarginine (SDMA) has been shown to increase and to correlate with plasma creatinine concentrations. HYPOTHESIS: In cats, reduced GFR corresponds with increased serum SDMA concentration. ANIMALS: The study group consisted of ten client-owned cats whose GFR had been measured previously. Cats ranged in age from 11.1 to 16.9 years; both azotemic and nonazotemic animals were included. METHODS: Glomerular filtration rate was determined for each cat by plasma iohexol clearance using the three sample slope-intercept method, and serum SDMA concentration was measured by liquid chromatography-mass spectrometry. RESULTS: A linear relationship was observed between GFR and the reciprocal of serum SDMA concentration (R(2) = 0.82, P < .001). A similar relationship was found between GFR and the reciprocal of plasma creatinine concentration (R(2) = 0.81, P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Increased serum SDMA concentrations were observed in cats with reduced renal function as determined by direct measurement of GFR. This finding indicates that SDMA could have clinical applications in the diagnosis of CKD in cats.

The relationship between patient-staff ratio and reported patient incidents.

The relationship between patient-staff ratio and the prevalence of patient incidents, such as assaults, fighting, suicides, falls, and abuse of patients by staff, was examined at an urban inpatient psychiatric center. Stepwise logistic regression was used to analyze 5,375 shifts in 14 high-incident wards representing five types of inpatient services; sample periods from three different years were examined. At least one incident occurred during 411 shifts (7.6 percent). More incidents occurred on the day shift and on two specific wards, confirming previous findings of a relationship between incidents and time of day as well as patient characteristics and milieu. However, no relationship between patient-staff ratio and the occurrence of incidents was found. This finding suggests that small increases in the number of ward staff may not reduce the number of patient incidents.

Incident reporting: evaluation of New York's pilot incident logging system.

A revised incident reporting system that combined an abbreviated logging procedure for documenting minor incidents and a more comprehensive and detailed procedure for documenting major incidents was pilot tested in three New York State adult psychiatric centers. The pilot test had two major goals: to reduce the volume of work associated with current reporting procedures, and to facilitate even more thorough investigation of incidents warranting prompt and comprehensive review. Evaluation of pilot study data showed that a logging procedure is viable for the management of minor incidents.

Constructing an efficient inpatient incident reporting system.

The NYS Office of Mental Health invests significant staff resources in documenting, investigating, and reviewing minor incidents. This process generates an enormous amount of paperwork. A study by the NYS Commission on Quality of Care revealed that this investment, in fact, compromised the intended positive outcomes. A major flaw they cited was the requirement for identical reporting procedures for both major and minor incidents. A logging system for reporting minor incidents was developed and pilot tested in three OMH psychiatric hospitals. The study revealed that utilization of a log system for the reporting of minor incidents greatly reduced paperwork and staff time, and that these reductions were accomplished without detriment to the quality of care. In fact, the quality of patient care may have improved. More incidents were being reported, a stable record was available on wards for clinical review, staff were enthusiastic about the log system, perhaps improving their morale, and direct care staff had more time available to spend with patients. This type of logging system for the reporting of minor incidents would appear applicable to practically all inpatient psychiatric settings, and, if employed as intended, could be expected to contribute to an improved quality of patient care.

Factors associated with a successful insanity plea.

The authors present data on all insanity pleas (N = 202) in Erie County, New York, between 1970 and 1980. No demographic, criminal history, current offense, or history of mental hospitalization factor was associated with acquittal. Of the variables studied, only the recommendation of the forensic examiner was associated with the court's decision to acquit by reason of insanity. When an insanity acquittal was recommended in the examination report, conviction ensued in only 17% of the cases. The proportion of pleas that were successful varied considerably over the 10 years studied. The authors discuss the critical need for more research on the plea stage of insanity defense proceedings.

Community mental health treatment: what works for whom?

The research literature does not establish with any consistency an integrated model of what type of patient functions best in what type of community setting. The findings do, however, identify the relationship of certain patient characteristics to re-hospitalization: number of prior hospitalizations, length of hospitalization and history of unemployment being positively related; educational level, occupational level, and race being unrelated; and sex, marital status, age, and diagnosis being inconsistently related. Also identified in the literature were those community programs that were found to be the most effective based on a review of four outcome measures including recidivism, symptomatology, social functioning, and employment.